Organization Active NPI

Big Gym Therapy, LLC

  • Pediatric Physical Therapist
  • Marietta, GA
National Provider Identifier
1710322706
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
Legal business name
BIG GYM THERAPY, LLC
Practice address
4005 Canton Rd
Marietta, GA 30066-2739
Phone
(770) 728-8833
Fax
(678) 668-7469
NPI assigned
May 3, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Renee Robertson Maddux, P.T.NPI 1063572808
Title
Member
Phone
(678) 736-0724

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Pediatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251P0200X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X

Addresses

Primary practice location

4005 Canton Rd
Marietta, GA 30066-2739

Mailing address

4005 Canton Rd
Marietta, GA 30066-2739
Phone (770) 728-8833

National Provider Directory

National Provider Directory

Locations

4005 Canton Rd
Marietta, GA 30066
Phone (770) 728-8833

10495 Woodstock Rd
Roswell, GA 30075

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1367539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753228800000",
    "number": "1710322706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4005 CANTON RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300662739",
            "telephone_number": "770-728-8833",
            "fax_number": "678-668-7469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 CANTON RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300662739",
            "telephone_number": "770-728-8833",
            "fax_number": "678-668-7469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIG GYM THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-03",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A",
        "authorized_official_last_name": "MADDUX",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "ROBERTSON",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "678-736-0724",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.